Systems and methods for onscreen menus in a teleoperational medical system

ABSTRACT

A system comprises a teleoperational assembly including an operator input system and a teleoperational manipulator configured for operation by the operator input system. The teleoperational manipulator is coupled to a medical instrument in a surgical environment. The system also comprises a processing unit including one or more processors. The processing unit is configured to retrieve a user profile for a user, the user profile including a parameter established during a prior teleoperational procedure. The parameter includes an ergonomic setup for an input device of the operator input system. The input device is configured to operate the teleoperational manipulator. The processing unit is also configured to provide instructions to configure an operation of the teleoperational assembly based upon the parameter. The operation includes adjusting the operator input system based on the at least one of the ergonomic setup for the operator input system.

RELATED APPLICATIONS

This patent application is a continuation of U.S. patent applicationSer. No. 16/324,891 filed Feb. 11, 2019, which is the U.S. nationalphase of International Application No. PCT/US2017/046446, filed Aug. 11,2017, which designated the U.S. and claims priority to and the benefitof the filing date of U.S. Provisional Patent Application 62/374,254,entitled “SYSTEMS AND METHODS FOR ONSCREEN MENUS IN A TELEOPERATIONALMEDICAL SYSTEM,” filed Aug. 12, 2016, all of which are incorporated byreference herein in their entirety.

FIELD

The present disclosure is directed to systems and methods for performinga teleoperational medical procedure and more particularly to systems andmethods for providing personalized user configurations.

BACKGROUND

Minimally invasive medical techniques are intended to reduce the amountof tissue that is damaged during invasive medical procedures, therebyreducing patient recovery time, discomfort, and harmful side effects.Such minimally invasive techniques may be performed through naturalorifices in a patient anatomy or through one or more surgical incisions.Through these natural orifices or incisions, clinicians may insertmedical tools to reach a target tissue location. Minimally invasivemedical tools include instruments such as therapeutic instruments,diagnostic instruments, and surgical instruments. Minimally invasivemedical tools may also include imaging instruments such as endoscopicinstruments. Imaging instruments provide a user with a field of viewwithin the patient anatomy. Some minimally invasive medical tools andimaging instruments may be teleoperated or otherwise computer-assisted.As teleoperational medical systems and teleoperated medical proceduresbecome increasingly complex, more efficient and personalized systems andmethods for configuring the teleoperational medical systems andprocedures are needed.

SUMMARY

The embodiments of the invention are summarized by the claims thatfollow below.

In one embodiment, a system comprises a teleoperational assemblyincluding an operator control system and a teleoperational manipulatorconfigured for operation by the operator control system. Theteleoperational manipulator is coupled to a medical instrument in asurgical environment. The system also comprises a processing unitincluding one or more processors. The processing unit is configured toretrieve a user profile for a user. The user profile including aparameter established during a prior teleoperational procedure. Theprocessing unit is also configured to provide instructions to configurean operation of the teleoperational assembly based upon the parameter.

In another embodiment, a system comprises a teleoperational assemblyincluding an operator control system and a teleoperational manipulatorconfigured for operation by the operator control system. Theteleoperational manipulator is coupled to a medical instrument in asurgical environment. The system also includes a processing unitincluding one or more processors. The processing unit is configured toretrieve a user profile for a user, that includes a parameterestablished by an operator input. The processing unit is also configuredto provide instructions to configure an operation of the teleoperationalassembly based upon the parameter.

In another embodiment, a method comprises determining an identity of auser at an operator control system of a teleoperational assembly. Theteleoperational assembly includes a teleoperational manipulatorconfigured for teleoperation by the operator control system. The methodalso includes retrieving a user profile for the user. The user profileincludes a first parameter established during a prior teleoperationalprocedure. The method also includes configuring an operation of ateleoperational assembly, based on the first parameter, during a currentteleoperational procedure.

BRIEF DESCRIPTIONS OF THE DRAWINGS

Aspects of the present disclosure are best understood from the followingdetailed description when read with the accompanying figures. It isemphasized that, in accordance with the standard practice in theindustry, various features are not drawn to scale. In fact, thedimensions of the various features may be arbitrarily increased orreduced for clarity of discussion. In addition, the present disclosuremay repeat reference numerals and/or letters in the various examples.This repetition is for the purpose of simplicity and clarity and doesnot in itself dictate a relationship between the various embodimentsand/or configurations discussed.

FIG. 1A is a schematic view of a teleoperational medical system, inaccordance with an embodiment of the present disclosure.

FIG. 1B is a perspective view of a patient side cart, according to oneexample of principles described herein.

FIG. 1C is a perspective view of a surgeon's control console for ateleoperational medical system, in accordance with many embodiments.

FIG. 2 is a system for maintaining a user profile.

FIG. 3 is a method for conducting a teleoperational medical procedureusing retrieved profiles.

DETAILED DESCRIPTION

For the purposes of promoting an understanding of the principles of thepresent disclosure, reference will now be made to the embodimentsillustrated in the drawings, and specific language will be used todescribe the same. It will nevertheless be understood that no limitationof the scope of the disclosure is intended. In the following detaileddescription of the aspects of the invention, numerous specific detailsare set forth in order to provide a thorough understanding of thedisclosed embodiments. However, it will be obvious to one skilled in theart that the embodiments of this disclosure may be practiced withoutthese specific details. In other instances well known methods,procedures, components, and circuits have not been described in detailso as not to unnecessarily obscure aspects of the embodiments of theinvention.

Any alterations and further modifications to the described devices,instruments, methods, and any further application of the principles ofthe present disclosure are fully contemplated as would normally occur toone skilled in the art to which the disclosure relates. In particular,it is fully contemplated that the features, components, and/or stepsdescribed with respect to one embodiment may be combined with thefeatures, components, and/or steps described with respect to otherembodiments of the present disclosure. In addition, dimensions providedherein are for specific examples and it is contemplated that differentsizes, dimensions, and/or ratios may be utilized to implement theconcepts of the present disclosure. To avoid needless descriptiverepetition, one or more components or actions described in accordancewith one illustrative embodiment can be used or omitted as applicablefrom other illustrative embodiments. For the sake of brevity, thenumerous iterations of these combinations will not be describedseparately. For simplicity, in some instances the same reference numbersare used throughout the drawings to refer to the same or like parts.

The embodiments below will describe various instruments and portions ofinstruments in terms of their state in three-dimensional space. As usedherein, the term “position” refers to the location of an object or aportion of an object in a three-dimensional space (e.g., three degreesof translational freedom along Cartesian X, Y, Z coordinates). As usedherein, the term “orientation” refers to the rotational placement of anobject or a portion of an object (three degrees of rotationalfreedom—e.g., roll, pitch, and yaw). As used herein, the term “pose”refers to the position of an object or a portion of an object in atleast one degree of translational freedom and to the orientation of thatobject or portion of the object in at least one degree of rotationalfreedom (up to six total degrees of freedom). As used herein, the term“shape” refers to a set of poses, positions, or orientations measuredalong an object.

Referring to FIG. 1A of the drawings, a teleoperational medical systemfor use in, for example, medical procedures including diagnostic,therapeutic, or surgical procedures, is generally indicated by thereference numeral 10. As will be described, the teleoperational medicalsystems of this disclosure are under the teleoperational control of asurgeon. In alternative embodiments, a teleoperational medical systemmay be under the partial control of a computer programmed to perform theprocedure or sub-procedure. In still other alternative embodiments, afully automated medical system, under the full control of a computerprogrammed to perform the procedure or sub-procedure, may be used toperform procedures or sub-procedures. As shown in FIG. 1A, theteleoperational medical system 10 generally includes a teleoperationalassembly 12 mounted to or near an operating table O on which a patient Pis positioned. The teleoperational assembly 12 may be referred to as apatient side cart when configured as part or all of a cart or whencapable of being placed in a cart. A medical instrument system 14 and anendoscopic imaging system 15 are operably coupled to the teleoperationalassembly 12. An operator input system 16 allows a surgeon or other typeof clinician S to view images of or representing the surgical site andto control the operation of the medical instrument system 14 and/or theendoscopic imaging system 15. The operator input system 16 may also bereferred to as a control console 16. In various embodiments, theoperator input system 16 may be adaptable for use with one of aplurality of types of teleoperational systems, including, for examplemulti-port and single port teleoperational platforms.

The operator input system 16 may be located at a surgeon's console,which is usually located in the same room as operating table O. Itshould be understood, however, that the surgeon S can be located in adifferent room or a completely different building from the patient P.Operator input system 16 generally includes one or more controldevice(s) for controlling the medical instrument system 14. The controldevice(s) may include one or more of any number of a variety of inputdevices, such as hand grips, joysticks, trackballs, data gloves,trigger-guns, foot pedals, hand-operated controllers, voice recognitiondevices, touch screens, body motion or presence sensors, and the like.In some embodiments, the control device(s) will be provided with thesame degrees of freedom as the medical instruments of theteleoperational assembly to provide the surgeon with telepresence, theperception that the control device(s) are integral with the instrumentsso that the surgeon has a strong sense of directly controllinginstruments as if present at the surgical site. In other embodiments,the control device(s) may have more or fewer degrees of freedom than theassociated medical instruments and still provide the surgeon withtelepresence. In some embodiments, the control device(s) are manualinput devices which move with six degrees of freedom, and which may alsoinclude an actuatable handle for actuating instruments (for example, forclosing grasping jaw end effectors, applying an electrical potential toan electrode, delivering a medicinal treatment, and the like).

The teleoperational assembly 12 supports and manipulates the medicalinstrument system 14 while the surgeon S views the surgical site throughthe console 16. An image of the surgical site can be obtained by theendoscopic imaging system 15, such as a stereoscopic endoscope, whichcan be manipulated by the teleoperational assembly 12 to orient theendoscopic imaging system 15. An electronics cart 18 can be used toprocess the images of the surgical site for subsequent display to thesurgeon S through the console 16. The number of medical instrumentsystems 14 used at one time will generally depend on the diagnostic orsurgical procedure and the space constraints within the operating roomamong other factors. The teleoperational assembly 12 may include akinematic structure of one or more non-servo controlled links (e.g., oneor more links that may be manually positioned and locked in place,generally referred to as a set-up structure) and a teleoperationalmanipulator. The teleoperational assembly 12 includes a plurality ofmotors that drive inputs on the medical instrument system 14. Thesemotors move in response to commands from the control system (e.g.,control system 20). The motors include drive systems which when coupledto the medical instrument system 14 may advance the medical instrumentinto a naturally or surgically created anatomical orifice. Othermotorized drive systems may move the distal end of the medicalinstrument in multiple degrees of freedom, which may include threedegrees of linear motion (e.g., linear motion along the X, Y, ZCartesian axes) and in three degrees of rotational motion (e.g.,rotation about the X, Y, Z Cartesian axes). Additionally, the motors canbe used to actuate an articulable end effector of the instrument forgrasping tissue in the jaws of a biopsy device or the like. Instruments14 may include end effectors having a single working member such as ascalpel, a blunt blade, an optical fiber, or an electrode. Other endeffectors may include, for example, forceps, graspers, scissors, or clipappliers.

The teleoperational medical system 10 also includes a control system 20.The control system 20 includes at least one memory 24 and at least oneprocessor 22, and typically a plurality of processors, for effectingcontrol between the medical instrument system 14, the operator inputsystem 16, and other auxiliary systems 26 which may include, forexample, imaging systems, audio systems, fluid delivery systems, displaysystems, illumination systems, steering control systems, irrigationsystems, and/or suction systems. The control system 20 also includesprogrammed instructions (e.g., a computer-readable medium storing theinstructions) to implement some or all of the methods described inaccordance with aspects disclosed herein. While control system 20 isshown as a single block in the simplified schematic of FIG. 1A, thesystem may include two or more data processing circuits with one portionof the processing optionally being performed on or adjacent theteleoperational assembly 12, another portion of the processing beingperformed at the operator input system 16, and the like. Any of a widevariety of centralized or distributed data processing architectures maybe employed. Similarly, the programmed instructions may be implementedas a number of separate programs or subroutines, or they may beintegrated into a number of other aspects of the teleoperational systemsdescribed herein. In one embodiment, control system 20 supports wirelesscommunication protocols such as Bluetooth, IrDA, HomeRF, IEEE 802.11,DECT, and Wireless Telemetry.

The control system 20 is in communication with a profile database 27which stores one or more user profiles. The profile database 27 may bestored in the memory 24 of the teleoperational system. Additionally oralternatively, the profile database 27 may be stored on a device such asa server or a portable storage device that is accessible by the controlsystem via an internal network (e.g., a secured network of a medicalfacility or a teleoperational system provider) or an external network(e.g., the Internet). The profile database 27 may be distributedthroughout two or more locations. For example, the database 27 may bepresent on multiple devices which may include the devices of differententities and/or a cloud server. Additionally or alternatively, theprofile database 27 may be stored on a portable user-assigned devicesuch as a computer, a mobile device, a smart phone, a laptop, anelectronic badge, a tablet, a pager, and other similar user devices.

In some embodiments, control system 20 may include one or more servocontrollers that receive force and/or torque feedback from the medicalinstrument system 14. Responsive to the feedback, the servo controllerstransmit signals to the operator input system 16. The servocontroller(s) may also transmit signals instructing teleoperationalassembly 12 to move the medical instrument system(s) 14 and/orendoscopic imaging system 15 which extend into an internal surgical sitewithin the patient body via openings in the body. Any suitableconventional or specialized servo controller may be used. A servocontroller may be separate from, or integrated with, teleoperationalassembly 12. In some embodiments, the servo controller andteleoperational assembly are provided as part of a teleoperational armcart positioned adjacent to the patient's body.

The control system 20 can be coupled with the endoscopic imaging system15 and can include a processor to process captured images for subsequentdisplay, such as to a surgeon on the surgeon's console, or on anothersuitable display located locally and/or remotely. For example, where astereoscopic endoscope is used, the control system 20 can process thecaptured images to present the surgeon with coordinated stereo images ofthe surgical site. Such coordination can include alignment between theopposing images and can include adjusting the stereo working distance ofthe stereoscopic endoscope.

In alternative embodiments, the teleoperational system may include morethan one teleoperational assembly and/or more than one operator inputsystem. The exact number of manipulator assemblies will depend on thesurgical procedure and the space constraints within the operating room,among other factors. The operator input systems may be collocated, orthey may be positioned in separate locations. Multiple operator inputsystems allow more than one operator to control one or more manipulatorassemblies in various combinations.

FIG. 1B is a perspective view of one embodiment of a teleoperationalassembly 12 which may be referred to as a patient side cart whenconfigured as part or all of a cart or when capable of being placed in acart. The teleoperational assembly 12 shown provides for themanipulation of three surgical tools 30 a, 30 b, 30 c (e.g., instrumentsystems 14) and an imaging device 28 (e.g., endoscopic imaging system15), such as a stereoscopic endoscope used for the capture of images ofthe site of the procedure. The imaging device may transmit signals overa cable 56 to the control system 20. Manipulation is provided byteleoperative mechanisms having a number of joints. The imaging device28 and the surgical tools 30 a-c can be positioned and manipulatedthrough incisions in the patient so that a kinematic remote center ismaintained at the incision to minimize the size of the incision. Imagesof the surgical site can include images of the distal ends of thesurgical tools 30 a-c when they are positioned within the field-of-viewof the imaging device 28.

The teleoperational assembly 12 includes a drivable base 58. Thedrivable base 58 is connected to a telescoping column 57, which allowsfor adjustment of the height of the arms 54. The arms 54 may include arotating joint 55 that both rotates and moves up and down. Each of thearms 54 may be connected to an orienting platform 53. The orientingplatform 53 may be capable of 360 degrees of rotation. Theteleoperational assembly 12 may also include a telescoping horizontalcantilever 52 for moving the orienting platform 53 in a horizontaldirection.

In the present example, each of the arms 54 connects to a manipulatorarm 51. The manipulator arms 51 may connect directly to a medicalinstrument such as a surgical tool (e.g. 30 a-c). The manipulator arms51 may be teleoperatable. In some examples, the arms 54 connecting tothe orienting platform are not teleoperatable. Rather, such arms 54 arepositioned as desired before the surgeon S begins operation with theteleoperative components.

Endoscopic imaging systems (e.g., system 15 and device 28) may beprovided in a variety of configurations including rigid or flexibleendoscopes. Rigid endoscopes include a rigid tube housing a relay lenssystem for transmitting an image from a distal end to a proximal end ofthe endoscope. Flexible endoscopes transmit images using one or moreflexible optical fibers. Digital image based endoscopes have a “chip onthe tip” design in which a distal digital sensor such as a one or morecharge-coupled device (CCD) or a complementary metal oxide semiconductor(CMOS) device store image data. Endoscopic imaging systems may providetwo- or three-dimensional images to the viewer. Two-dimensional imagesmay provide limited depth perception. Three-dimensional stereoendoscopic images may provide the viewer with more accurate depthperception. Stereo endoscopic instruments employ stereo cameras tocapture stereo images of the patient anatomy. An endoscopic instrumentmay be a fully sterilizable assembly with the endoscope cable, handleand shaft all rigidly coupled and hermetically sealed.

FIG. 1C is a perspective view of the console 16. The console 16 includesa left eye display 32 and a right eye display 34 for presenting thesurgeon S with a coordinated stereo view of the surgical environmentthat enables depth perception. The console 16 further includes one ormore input control devices 36, which in turn cause the teleoperationalassembly 12 to manipulate one or more instruments or the endoscopicimaging system. The input control devices 36 can provide the samedegrees of freedom as their associated instruments 14 to provide thesurgeon S with telepresence, or the perception that the input controldevices 36 are integral with the instruments 14 so that the surgeon hasa strong sense of directly controlling the instruments 14. To this end,position, force, and tactile feedback sensors (not shown) may beemployed to transmit position, force, and tactile sensations from theinstruments 14 back to the surgeon's hands through the input controldevices 36. Input control devices 37 are foot pedals that receive inputfrom a user's foot.

Many aspects of the console 16, the teleoperational assembly 12, and theauxiliary systems 26 are adjustable and customizable to meet thephysical needs, skill level, or preferences of the surgeon S.Configuring the systems to match the surgeon's needs, skill set, andpreferences can be time consuming if it has to be performed for eachsurgical procedure. Furthermore, surgeons may be unaware of new featuresof the systems or procedural efficiencies developed by otherpractitioners. Consequently, some clinicians accept suboptimal ergonomicconditions or fail to recognize possible procedural efficiencies whenperforming procedures.

As described in detail below, a user profile may be created for eachuser of the teleoperational system 10 to store a variety of personalizeddata including identification information, training history,credentials, procedure history, communication preferences, ergonomicpreferences, equipment preferences, and interface preferences. Theprofile may be accessed before, during, and after each simulator,training, or actual surgical procedure conducted by the surgeon toconfigure the surgical environment, equipment, user interface, andcommunications to the user.

FIG. 2 illustrates a system 100 for maintaining a user profile. Thesystem 100 includes a profile database 102 (e.g., database 27) incommunication with multiple systems and devices including, for example,a teleoperational surgical system 104 (e.g., system 10), ateleoperational surgical system 106, a simulator system 108, and a datainput device 110 including, for example, a mobile phone, smart phone,tablet computer, laptop computer, wearable mobile device, desktopcomputer, pager, electronic badge, or other similar user devices thatmay passively or actively receive information from or about the user.One or more of the systems 104, 106, 108 or the device 110 may beomitted from the system. Alternatively, the profile database may be incommunication with may more systems and devices than those shown in FIG.2 . For example, the profile database may reside on a server of ateleoperation system manufacturer and may be in communication withthousands of the manufacturers teleoperational systems distributedacross the world. As previously described, the profile database 102 maybe accessible to one or more of systems or devices 104, 106, 108, 110via one or more networks. The one or more networks may include anysuitable combination of cable, cellular, radio, digital subscriber line,or any other suitable network, which may be wired and/or wireless. Insome examples, network communication may be conducted over a wirelessmedium, e.g., using Bluetooth, IrDA, HomeRF, IEEE 802.11, DECT, WirelessTelemetry or other protocols for wireless data communication. Theprofile database 102 may include records, tables, arrays, and the like,which may be relational or non-relational.

The simulator system 108 may be provided to a surgeon or other operatorof a teleoperational system to create an environment in which topractice a given operation to develop facility with the system and tovalidate the selected entry port locations. Generally, the simulatorsystem may include teleoperational control mechanisms, a computer with amonitor, and computer software to enable the simulation. Using asimulation, a surgeon can essentially perform the operation as it wouldbe performed on a live patient, as simulated on a 3-dimensionalrepresentation on a computer monitor.

The profile database 102 include a user record 103 (also called profile103) for each of a plurality of users of the systems and devices 104,106, 108, 110. The record 103 for each user may include a trainingrecord 112, a credential record 114, a procedure history record 116, acommunication preference record 118, an anthropometric record 120, anequipment preference record 122, and an interface preference record 124.Additional or alternative types of user-specific records may also bestored for some or all of the users.

The training record 112 may include, for example, a cumulative record ofthe user's simulator experience and proctor-assisted procedureexperience, including the types of procedures, the outcome of theprocedures, and any issues occurring during the procedures. It may alsoinclude evaluations, certifications, and a cumulative log of hours intraining. The training record 112 may be updated after each trainingepisode for a user. For example, after conducting a simulation exercisewith simulator system 108, the simulator may communicate with thetraining record 112 for User A and update it to reflect completion ofthe simulation exercise.

The credentials record 114 may include, for example, credentials orother rights to use the systems and devices 104, 106, 108, 110 or accessspecific procedures with those systems. Credentials may be issued by anissuing authority such as a trainer, a medical facility (e.g., ahospital, clinic, training center). For example, if User A is authorizedby a hospital to use an on-site teleoperational system, a computer(e.g., device 110) may be used to update the credential record 114 forUser A. The credential record 114 may be used to limit the access of theuser to any of the systems or devices 104, 106, 108, 110. For example auser who is a systems engineer and not a surgeon may have credentialsthat allows limited access to system 104 controls (e.g., controlling adisplay screen brightness) but restricts access to other functions(e.g., manipulation of the surgical instruments when a patient ispresent). The credential record may limit user access to procedures,instruments, and functions of the system 104 if the proper credential isnot found in the credential record 114.

The procedure record 116 may include experience statistics including acount of procedures performed, types of procedures performed, speed ofprocedures performed, and transition times for prior procedures. Therecord 116 may further include the software version and model of thesystem used for each procedure. As described below, data from a user'sprocedure record may be compared with current software, equipment model,or procedure information to provide assistance or warnings to the userabout differences or changes that may distinguish the current procedurefrom prior procedures. The procedure record 116 may be updated duringand/or after each procedure conducted by User A via, for example,communication with the surgical system on which the procedure wasperformed

The communication preferences record 118 may include a record of thelanguages in which the user is fluent and preferred languages for audioand/or textual communication. The communication record may also includeUser A's preferences regarding the medium for delivery of communication(e.g., visual, auditory, combined visual and auditory); volume settings;and preferred frequency of reminders and warnings. The communicationpreferences record 118 may be updated, for example, by User A using asmart phone (e.g., device 110) application that accesses the record.Alternatively, the record 118 may be updated to record the most recentcommunications selections during a procedure as the defaultcommunication settings for the next procedure.

The anthropometric record 120 may include anatomic measurements takenfor User A including, for example, optometric measurements of User A'svision and any needed corrective lenses, intraocular spacing, height,weight, handedness, and physical limitations. The information from theanthropometric record 120 may be used to optimize the ergonomicconfiguration of the surgeon console viewer, including the eye displays32, 34. For example, the anthropometric record information may be usedto configure viewer height and viewer angle. The anthropometric record120 may also include, for example, the distance between a user's elbowsand eyes for determining the distance between the armrest of the surgeonconsole and the eye displays (e.g., the arm rest heights). Theanthropometric record 120 may also include, for example, the length of auser's forearm for determining a centered neutral position for themaster controls. The anthropometric record 120 may also include, forexample, the length of the user's legs from hip flexor to knees fordetermining the position of the foot pedal tray. The anthropometricrecord 120 may be updated by data entry through a computer (e.g., device110). Additionally or alternatively, a system 104, 106, 108 may includemeasurement devices to capture the anthropometric data while the user isengaged with the system.

The equipment preferences record 122 may include User A's preferencesregarding optional arrangements, functions, and settings of componentsof a teleoperational system (e.g., system 10, 104, 106). The record 122may include some user preferences and settings that pertain to specifictypes of assemblies 12 and some user preferences and settings thatpersist for any type of assembly 12. For example, the record 122 mayinclude preferred hand positions and button/pedal function assignmentsfor the control console 16. The record 122 may include the User A'spreferred configuration of the assembly 12 relative to the patient. Therecord 122 may include preferred instrument (e.g., instrument 14)settings such as electrocautery power levels, coagulation/cut energylevels, force, torque, staple cartridge, and handedness for stapler. Therecord 122 may include preferred tele-operation associations betweenmaster controls and the controlled manipulator and/or instrument. Therecord 122 may include a preferred arrangement of the endoscope andinstrument types on each of the manipulator arms. The record 122 mayalso include dominant and non-dominant hand assignments, such as theauxiliary instrument arm preference for the left or right side. Therecord 122 may include preferred port placements and arm configurations.The record 122 may include preferred functionality such as table motionor microsurgery capability. For example, preferred preset tablepositions (e.g., trendelenburg and tilt angles) may be stored fordifferent phases of the procedure. The record 122 may includepreferences regarding auxiliary equipment (e.g., auxiliary system 26)including supplemental imaging systems (e.g., MRI, x-ray, ultrasound);video input and output; carbon dioxide settings; insufflation pressureand flow rate preferences based on patient condition and phase of theprocedure; and audio settings (e.g., which microphones activated,feedback suppression, which speakers activated, use of voice prompts).The record 122 may be updated to record the most recent equipmentsettings during a procedure as the default communication settings forthe next procedure or may default to the most frequently used settings.

The user interface record 124 may include User A's preferences regardingthe graphical user interface, other sensory displays, or the endoscopicinstrument settings. For example, the record 124 may include preferencesregarding vision correction and autofocus. The record 124 may alsoinclude User A preferences for display color, brightness, contrast,shadow, dynamic contrast, color tone, and use of near infrared imaging.The record 124 may also include User A's preferences regarding imageprocessing enhancements for specular reflection removal, smoke removal,and noise suppression. The record 124 may also include User A'spreferences regarding thresholds and filters for fluorescence imaging,segmentation, and interpretation. The record 124 may also include UserA's preferences regarding the information visible to User A at thecontrol console 16 and the arrangement of the information in tiles orother configurations on the display. The record 124 may also includeUser A's preferences regarding graphical overlays on the endoscopicimage, including the opacity of the graphical overlays.

The profile database 102 may also include facility records 130 thatinclude information about each facility housing surgical systems (e.g.,10, 104, 106). The record 130 may include, for example, the availabilityor scheduling of local systems, credential requirements for thefacility, training requirements for the facility, and auxiliaryequipment available at the facility. The facility record 130 may be usedtogether with the user record 103 to configure a surgical system at thefacility. For example, a Facility A at which a surgical system 104 islocated, may include a record 130 requiring an authorization credential.The User A credential record 114 must include the authorizationcredential or the User A will be denied access to the system 104 and anyother systems at Facility A.

The profile database 102 may also include procedure records 132 thatinclude information about various procedures that may be performed withthe teleoperational systems. Each procedure record 132 may include, forexample, the current procedure sequence, best-practices for performingthe procedure, instruments needed to perform the procedure, and thetraining level required to perform the procedure. The proceduresequence, best practices, and needed instruments may be predetermined byan administrator, instructor, or other authority. Alternatively, theserecords may be recorded from a prior teleoperational procedure. Theprocedure record 132 may be used together with the user record 103 toprepare for a procedure. For example, if the best practices forperforming procedure A from record 132 have changed since the last timethe User A performed the type of procedure A, (as recorded in the User Aprocedure history record 116), a visual or auditory message explainingthe differences may be provided to the User A before commencing thecurrent procedure A.

The profile database 102 may also include equipment records 134 thatinclude information about equipment of the surgical systems (e.g., 10,104, 106). Each record 134 may include, for example, software revisioninformation and functional capability for the control console, controlsystem, teleoperational assemblies, auxiliary equipment, and surgicalinstruments. The equipment record 134 may be used together with the userrecord 103 to prepare for a surgical system for use. For example, if therecord 134 indicates that the current software running on system 104 isa newer revision compared to the last time User A used the system, avisual or auditory message explaining the differences may be provided toUser A before commencing use of the system 104.

Referring now to FIG. 3 , a method 150 for conducting a teleoperationalmedical procedure using retrieved user profiles is illustrated. At aprocess 152, a potential user of a teleoperational medical system (e.g.,a system 10) is detected and identified. For example, the controlconsole 16 may include an identity detection system 17 for detectingidentifying information about a user. The identity detection system 17may include a head-in console iris or retinal scan recognition system, afingerprint recognition system, a voice recognition system, a facialrecognition system or other physiologic recognition system.Alternatively, the identity detection system may be based on auser-assigned identification badge using, for example radio frequencyidentification (RFID), magnetic strip, bar code, proximity care, orcontact card technology. In various alternatives, the identity detectionsystem, using any of the above described technologies, may beginidentity detection when one or more users enter a predetermined areasuch as the operating room. After detecting one or more identifyingcharacteristics, the characteristics may be compared to information fromthe user profiles from the profile database 102. For example, thecollected identifying characteristics may be compared to anthropometricrecords 120 and/or credential records 114. In one example,anthropometric record 120 may include retinal measurements for User A.If those retinal measurements match detected retinal measurements fromthe identity detection system 17, the identity of the user is determinedto be User A. In another example, credential records 114 may includeRFID data associated with User A. If RFID data gathered from theidentity detection system 17 matches the RFID data for an authorizedUser A, User A is identified as an authorized user.

At a process 154, if the identity of the user is determined, the userprofile from the profile database 102 is retrieved. At a process 156, adefault profile may be retrieved if the identity of the user may not bedetermined. Optionally, if the identity of the user is not determined,no profile is retrieved and the user is unable to use theteleoperational system 10. Alternatively, if the identity of the user isnot determined, the identity may be verified manually by authorizedadministrative personnel with alerts provided to indicate that anon-credentialed user was operating at the console for a recorded periodof time.

At a process 158, the teleoperational system 10 is configured based uponthe personal profile of the identified user. For example, if User A isidentified as the user, the records of profile 103 are used to configurethe teleoperational system.

At a process 160, communications to User A may be configured. Forexample, pop-up messages, warnings, or other indications may be providedto User A based on information from the procedure history record 116. Invarious examples, the a message may alert User A that the system isrunning a software revision that includes additional features addedsince the last time User A conducted the same procedure, that a featurethat they regularly use for the procedure is not available, or that (incombination with records 132) the user may be interested in trying a newfeature or procedure sequence to improve efficiency or safety.Communications may also be configured based on a detected emotionalstate of the user (e.g., using iris detection, measured changes in bodytemperature, measure changes in perspiration). In another example,messaging may also be based upon training record 112 and may includeproviding a pop-up recommendation that User A use a proctor or trainerfor the procedure. In another example, messaging may be provided tosuggest body repositioning to allow User A to better view the fulldisplay.

Aspects of the user messaging such as the language, location, duration,and volume (if an audio or video message) may be determined by thecommunication records 118 of the profile 103. The provided messages maybe acknowledged and cleared using any of a variety of techniquesincluding clicking an acknowledgement on the user interface, trackinguser's eye gaze to ensure that the message was read, providing a test orother comprehension evaluation, or requiring the user to perform anactivity such as trying a new feature of the system. After the user hascompleted the requisite acknowledgement, the message may be omitted forsubsequent procedures or may be provided only a limited number ofsubsequent times. Similarly, if the user's procedure history indicatesthat the user has acquired a threshold level of experience in aprocedure the frequency of some messages (e.g., assistance messages orwarnings) may be reduced or eliminated.

At a process 162, the equipment of the teleoperational system 10 may beconfigured based, for example, on the equipment preferences record 122,anthropometric record 120, training record 112, credential record 114,and/or procedural history record 116. For example, preferred handpositions and button/pedal function assignments may be made for thecontrol console 16. The preferred configuration of the assembly 12relative to the patient may be set-up. Preferred instrument settings maybe set, such as ablation power levels, energy, force, torque, staplecartridge, and handedness for stapler. Other preferences including portplacements, arm configurations, table motion or microsurgery capabilitymay be implemented. Preferences regarding auxiliary equipment (e.g.,auxiliary system 26) including supplemental imaging systems (e.g., MRI,x-ray, ultrasound); video input and output; carbon dioxide settings; andaudio settings (e.g., which microphones activated, feedback suppression,which speakers activated, use of voice prompts) may also be implemented.

The process 162 of configuring the equipment of the teleoperationalsystem may further include determining the type of teleoperationalassembly 12 being used in the present procedure and configuring theequipment based on the type of teleoperational assembly. For example,motion scale settings may be selected based a user record that appliesdifferent motion scale settings depending on the type of teleoperationalassembly performing the present procedure. Some equipment configurationsettings in the user profile may be equivalent across differentteleoperational platforms (e.g., image brightness, speaker volume), butother settings of the user profile that are inherently distinct tointeractions with particular platforms may be persisted separately.

At a process 164, the user interface, including the graphical userinterface visible on the display of the console 16, is configured based,for example on the interface preference record 124, the anthropometricrecord 120, the training record 112, the credential record 114, and/orthe procedural history record 116. For example, vision correction andautofocus preferences may be configured by adjustments on the console 16or the endoscopic system 15. Adjustments for display color, brightness,contrast, shadow, dynamic contrast, and use of near infrared imaging maybe made. User A's preferences regarding the information visible to UserA at the control console 16 and the arrangement of the information intiles or other configurations on the display may also be implemented.User A's preferences regarding graphical overlays on the endoscopicimage, including the opacity of the graphical overlays may also beimplemented.

At a process 166, other adjustable aspects of the user environment maybe configured based upon the records for the profile 103. If at process156, a default profile was retrieved, a default or test set-upconfiguration of the communications system, equipment, and userinterfaces may be implemented. Optionally, some of the default settingsmay be adjusted by the unidentified user.

At a process 168, User A conducts the teleoperational medical procedureusing the configurations based upon the user profile 103. Throughout theprocedure, communications, equipment, user interfaces, and other aspectsof the user's environment may be controlled by the user profile 103.

At a process 170, if User A makes configuration changes that differ frompreferences stored in the records of the profile 103, the system mayupdate the profile or may query the user to determine whether the userwould like the changed configurations to replace (either entirely orcontextually) preferences stored in the records of the profile. The userprofile is also accessible outside of the surgical environment so that auser can import, export, and modify parameters of the profile. Profilesmay also be created, deleted, and populated by an administrator. Anadministrator may also populate the profile with procedures for whichthe user has been credentialed to perform.

One or more elements in embodiments of the invention may be implementedin software to execute on a processor of a computer system such ascontrol processing system. When implemented in software, the elements ofthe embodiments of the invention are essentially the code segments toperform the necessary tasks. The program or code segments can be storedin a processor readable storage medium or device that may have beendownloaded by way of a computer data signal embodied in a carrier waveover a transmission medium or a communication link. The processorreadable storage device may include any medium that can storeinformation including an optical medium, semiconductor medium, andmagnetic medium. Processor readable storage device examples include anelectronic circuit; a semiconductor device, a semiconductor memorydevice, a read only memory (ROM), a flash memory, an erasableprogrammable read only memory (EPROM); a floppy diskette, a CD-ROM, anoptical disk, a hard disk, or other storage device. The code segmentsmay be downloaded via computer networks such as the Internet, Intranet,etc.

Note that the processes and displays presented may not inherently berelated to any particular computer or other apparatus. Variousgeneral-purpose systems may be used with programs in accordance with theteachings herein, or it may prove convenient to construct a morespecialized apparatus to perform the operations described. The requiredstructure for a variety of these systems will appear as elements in theclaims. In addition, the embodiments of the invention are not describedwith reference to any particular programming language. It will beappreciated that a variety of programming languages may be used toimplement the teachings of the invention as described herein.

While certain exemplary embodiments of the invention have been describedand shown in the accompanying drawings, it is to be understood that suchembodiments are merely illustrative of and not restrictive on the broadinvention, and that the embodiments of the invention not be limited tothe specific constructions and arrangements shown and described, sincevarious other modifications may occur to those ordinarily skilled in theart.

1-51. (canceled)
 52. A system comprising: a teleoperational assemblyincluding an operator input system and a teleoperational manipulatorconfigured for operation by the operator input system, wherein theteleoperational manipulator is coupled to a medical instrument in asurgical environment; and a processing unit including one or moreprocessors, wherein the processing unit is configured to: retrieve auser profile for a user, the user profile including a parameterestablished during a prior teleoperational procedure, wherein theparameter includes an ergonomic setup for an input device of theoperator input system, the input device configured to operate theteleoperational manipulator and provide instructions to configure anoperation of the teleoperational assembly based upon the parameter,wherein the operation includes adjusting the operator input system basedon the at least one of the ergonomic setup for the operator inputsystem.
 53. The system of claim 52, wherein the processing unit isfurther configured to determine an identity of the user, wherein theuser profile is associated with the identity.
 54. The system of claim53, wherein determining the identity of the user includes receivingbiometric information about the user.
 55. The system of claim 52,wherein retrieving the user profile includes retrieving the user profileover a network from a profile storage database.
 56. The system of claim52, wherein the parameter further includes a procedural sequence of theprior teleoperational procedure.
 57. The system of claim 56, wherein theoperation further includes providing a message to the user based on theprocedural sequence.
 58. The system of claim 57, wherein the processingunit is further configured to clear the message based on an indicationof an activity completed by the user.
 59. The system of claim 56,wherein the operation further includes adjusting a setting of theoperator input system based on the procedural sequence of the priorteleoperational procedure.
 60. The system of claim 52, wherein theparameter further includes anthropometric data for the user.
 61. Thesystem of claim 60, wherein the operation further includes adjusting theoperator input system based on the anthropometric data.
 62. The systemof claim 61, wherein the operation includes adjusting an operating tablebased on the anthropometric data.
 63. The system of claim 52 wherein theparameter further includes a credential issued to the user based on theprior teleoperational procedure.
 64. The system of claim 52 wherein theparameter further includes a setting for the medical instrument based ona user preference established during the prior teleoperationalprocedure.
 65. The system of claim 52 wherein the parameter furtherincludes a setting for auxiliary equipment.
 66. The system of claim 52,wherein the parameter further includes at least one of an ergonomicsetup for the operator input system, a vision correction setting, apreferred language setting, or a preferred graphical user interfacesetting.
 67. The system of claim 52, wherein the prior teleoperationalprocedure was conducted by the user.
 68. The system of claim 52, whereinthe prior teleoperational procedure was conducted by another user. 69.The system of claim 52, wherein the prior teleoperational procedure wasa simulated teleoperational procedure.
 70. The system of claim 52,wherein the processing unit is further configured to determine a type ofthe teleoperational manipulator and wherein providing instructions toconfigure an operation of the teleoperational assembly is further basedon the type of the teleoperational manipulator.
 71. The system of claim70, wherein the type is a single port teleoperational manipulator or amulti-port teleoperational manipulator.